| NPI | 1467949602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX BP1678806) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD H0091024) |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2021-06-30 |